A record of a request for a procedure diagnostic investigations, treatments, or operations to be performed. May be a proposal or an order.

Identifiers assigned to this order instance by the order or by orderer and/or the receiver. receiver and/or order fulfiller.

The identifier.type element is used to distinguish between the identifiers assigned by the orderer (known as the 'Placer' in HL7 v2) and the producer of the observations in response to the order (known as the 'Filler' in HL7 v2). For further discussion and examples see the resource notes section below.

The person, animal Protocol or group that should receive the procedure. definition followed by this request.

Plan/proposal/order fulfilled by this request.

The specific request takes the place of the referenced completed or terminated request(s).

A shared identifier common to all procedure or diagnostic requests that is ordered. Use text were authorized more or less simultaneously by a single author, representing the composite or group identifier.

Some business processes need to know if multiple items were ordered as part of the exact nature same "requisition" for billing or other purposes.

Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the procedure cannot be coded. same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation.

The status of the order.

The status is generally fully in the control of the requester - they determine whether the order is draft or active and, after it has been activated, competed, cancelled or suspended. States relating to identify the activities of the performer are reflected on either the corresponding event (see Event Pattern for general discussion) or using the Task resource.

This element is labeled as a specific procedure . modifier because the status contains codes that mark the resource as not currently valid.

Whether the request is a proposal, plan, an original order or a reflex order.

This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.

Indicates how quickly the sites on ProcedureRequest should be addressed with respect to other requests.

Set this to true if the subject's body where record is saying that the procedure should NOT be performed (I.e. the target sites). performed.

Used for do not ambulate, do not elevate head of bed, do not flush NG tube, do not take blood pressure on a certain arm, etc.

This element is labeled as a modifier because it indicates that a procedure shouldn't happen, instead of a request for it to happen. In general, only the code and timeframe will be present, though occasional additional qualifiers such as body site or even performer could be included to narrow the scope of the prohibition. If the ProcedureRequest.code and ProcedureRequest.doNotPerform both contain negation, that will reinforce prohibition and should not have a double negative interpretation.

A code that identifies classifies the anatomical location. procedure for searching, sorting and display purposes (e.g. "Surgical Procedure").

Knowing where the procedure is made is important Used for tracking if multiple sites filtering what procedure request are possible. retrieved and displayed.

Only used if not implicit in There may be multiple axis of categorization depending on the code found context or use case for retrieving or displaying the resource. The level of granularity is defined by the category concepts in ProcedureRequest.type. the value set.

The reason why the procedure is being proposed or ordered. This procedure request may be motivated by A code that identifies a Condition for instance. particular procedure, diagnostic investigation, or panel of investigations, that have been requested.

Many laboratory and radiology procedure codes embed the specimen/organ system in the test ordeer name, for example, serum or serum/plasma glucose, or a chest xray. The specimen may not be recorded separately from the test code.

On whom or what the procedure or diagnostic is to be performed. This is usually a human patient, but can also be requested on animals, groups of humans or animals, devices such as dialysis machines, or even locations (typically for environmental scans).

An encounter or episode of care that provides additional information about the healthcare context in which this request is made.

The date/time at which the diagnostic testing should occur.

The timing schedule If a CodeableConcept is present, it indicates the pre-condition for performing the proposed or ordered procedure. The Schedule data type allows many different expressions. E.g. "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". For example "pain", "on flare-up", etc.

The encounter within which When the procedure proposal or request was created. transitioned to being actionable.

For example, The individual who initiated the surgeon, anaethetist, endoscopist, etc. request and has responsibility for its activation.

This not the dispatcher, but rather who is the authorizer.

The device, practitioner or organization who initiated the request.

The status of organization the order. device or practitioner was acting on behalf of.

Practitioners and Devices can be associated with multiple organizations. This element indicates which organization they were acting on behalf of when authoring the request.

Desired type of performer for doing the diagnostic testing.

this is a role, not a participation type. I.e. does not describe the task, but describes the capacity. For example, “compounding pharmacy” or “psychiatrist” or “internal referral”.

Any other notes associated with this proposal or order - e.g. provider instructions. The desired perfomer for doing the diagnostic testing. For example, the surgeon, dermatopathologist, endoscopist, etc.

If needed, use an extension for listing alternative performers and/or roles and/or preference.

If a CodeableConcept An explanation or justification for why this diagnostic investigation is present, it indicates the pre-condition being requested in coded or textual form. This is often for performing billing purposes. May relate to the procedure. resources referred to in supportingInformation.

This may be used to decide how the diagnostic investigation will be performed, or even if it will be performed at all. Use CodeableConcept text element if the data is free (uncoded) text as shown in the CT Scan example .

The time when Indicates another resource that provides a justification for why this diagnostic investigation is being requested. May relate to the request was made. resources referred to in supportingInformation.

This may be used to decide how the diagnostic investigation will be performed, or even if it will be performed at all. Use CodeableConcept text element if the data is free (uncoded) text as shown in the CT Scan example .

The healthcare professional responsible for proposing Additional clinical information about the patient or specimen that may influence the procedure or diagnostics or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the procedure. producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

One or more specimens that the laboratory procedure will use.

Many diagnostic procedures need a specimen, but the request itself is not actually about the specimen. This element is for when the diagnostic is requested on already existing specimens and the request points to the specimen it applies to. Conversely, If the request is entered first with an unknown specimen, The Specimen resource references to the ProcedureRequest.

The clinical priority associated with this order. Anatomic location where the procedure should be performed. This is the target site.

Knowing where the procedure is performed is important for tracking if multiple sites are possible.

Only used if not implicit in the code found in ProcedureRequest.type. If the use case requires BodySite to be handled as a separate resource instead of an inline coded element (e.g. to identify and track separately) then use the standard extension procedurerequest-targetBodySite .

Any other notes and comments made about the service request. For example, letting provider know that "patient hates needles" or other provider instructions.

Key events in the history of the request.

This may not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.